What is Health at Every Size (HAES)?

As a Registered Dietitian, I counsel and coach clients using the Health at Every Size approach. This is a bit unique in the health and wellness world, so I thought it would be helpful to write this post to explain Health at Every Size, why I practice in this way, and to clear up some common misconceptions.

Health at Every Size, or HAES®, is a weight-inclusive framework created by the Association for Size Diversity and Health (ASDAH). I was first made aware of the HAES paradigm and ASDAH as I began learning about intuitive eating while in grad school (2014). While I didn’t have an understanding of HAES at the time, my philosophy has always aligned well with this framework (though it took lots of listening and learning to fully come to embrace this practice).

My Journey to HAES

Throughout my education and first few years as a dietitian, I was able to witness first-hand that weight is not a sole predictor of health. I admittedly entered grad school thinking I was going to “cure” the “obesity epidemic”, and quickly learned that weight itself wasn’t necessarily something that needed to be fixed for most people. Rather, individuals were up against systems and policies that prevented adequate access to nourishing foods, safe spaces and time for physical activity, and comprehensive and compassionate medical care. As I began working with clients one-on-one, I saw patients in larger bodies who were doing everything “right” and had amazing lab work, but were still labeled as unhealthy simply because of their size. It never sat well with me, so I began looking into the science behind weight and realized it doesn’t tell us about someone’s health as much as we’d like to believe. Body diversity is a thing – some of us are made to be larger and some are meant to be smaller, and that’s ok! By respecting our natural body sizes, we can really get to addressing the root of our health issues.

Diving into the science around weight led me to read Lindo Bacon’s book Health at Every Size: The Surprising Truth about Your Weight (which I highly recommend reading if you’re new to Intuitive Eating and HAES). It was through this book that I was introduced to the HAES principles, and realized this was an approach I wanted to dive into further and apply to all aspects of my work.

Weight-Inclusive Care

The biggest shift for me was moving from weight-normative care to weight-inclusive care. Weight-normative is the approach to health that most of us are used to experiencing – weight and weight loss define health and well-being, and weight and health are inextricably linked. In contrast, a weight-inclusive approach acknowledges that health and well-being are multi-faceted and extremely individualized, and focuses on increasing access to health promoting behaviors and reducing weight stigma. In essence, weight does not need to be pathologized, and behaviors and access impact someone’s health more than their weight. Health and well-being are more than just the number on a scale.

The Health at Every Size Principles

A common misconception I see from critics (and one that I had when first learning about the framework) is that HAES practitioners and advocates believe people can be HEALTHY at every size. This is simply a misinterpretation and oversimplification of the entire paradigm. Folks at any size can be healthy or unhealthy. HAES is based on a set of five principles that assert individuals should have access and be able to participate in health promoting behaviors, regardless of body size. The HAES Principles, according to ASDAH, are:

1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
2. Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
3. Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
4. Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
5. Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

The HAES model can be applied to both policy and individual decision-making when it comes to health and well-being. I appreciate this since I work at both levels – public health and individual coaching – and believe that what we do at a policy level affects us as individuals and vice versa. If we want to truly support the health of all, we must be impacting individual, community, and national policies, systems, and environments. HAES supports this by acknowledging and addressing the many facets of health, including physical, mental, emotional, social, and economic.

HAES is Holistic Health

To me, HAES truly embraces a holistic approach to health and how we can make it accessible to everyone. I think it’s important to acknowledge as well that as individuals, we are able to define what “health” means to us, since it is different for everyone. My work is focused on helping you align your behaviors and actions with your unique definition of health. If you’re ever interested in working together to come up with strategies to best support your health, please don’t hesitate to reach out and apply for coaching.

What are your thoughts about the HAES approach? I’d love to hear from you!

Mindfully yours,
Sam